Provider Demographics
NPI:1689911026
Name:MAYS-VENN, MARY C (LPN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:C
Last Name:MAYS-VENN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 LYNBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2058
Mailing Address - Country:US
Mailing Address - Phone:419-382-0107
Mailing Address - Fax:
Practice Address - Street 1:5026 LYNBRIDGE LN
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2058
Practice Address - Country:US
Practice Address - Phone:419-382-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164W00000X164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse